引用本文:[点击复制]
[点击复制]
【打印本页】 【在线阅读全文】【下载PDF全文】 查看/发表评论下载PDF阅读器关闭

←前一篇|后一篇→

过刊浏览    高级检索

本文已被:浏览 116次   下载 25 本文二维码信息
码上扫一扫!
重症监护病房肺炎克雷伯菌临床特点及耐药分析
王纯睿,袁喆,周泓羽,杨政
0
(重庆医科大学附属第一医院感染科·重庆市传染病寄生虫病学重点实验室;重庆医科大学附属第一医院感染管理科;华中科技大学同济医学院附属荆州医院感染科)
摘要:
目的 分析重症监护病房(ICU)肺炎克雷伯菌感染的临床特点及耐药情况,为临床合理使用抗菌药物提供依据。方法 回顾性分析重庆医科大学附属第一医院2014年1月~2016年12月ICU肺炎克雷伯菌感染病例483例,药敏试验采用纸片扩散法,双纸片协同试验进行超广谱β内酰胺酶检测,WHONET5.6及SPSS 21.0软件统计分析数据。结果 ICU肺炎克雷伯菌感染常见于伴多种易患因素的老年患者,下呼吸道为主要感染部位;CREKp感染死亡率高,多合并感染性休克或多器官功能障碍。3年来ICU检出肺炎克雷伯菌对常用抗菌药物耐药率不同程度上升,特别是CREKp菌株分离逐渐增加且呈泛耐药特点,仅对替加环素、米诺环素敏感。结论 ICU肺炎克雷伯菌感染发病率高且病情重,CREKp感染死亡风险高,应充分认识其严重性。治疗上依据药敏试验结果指导临床选择适当抗菌药物尤为重要。
关键词:  肺炎克雷伯菌  耐药性  超广谱β内酰胺酶  重症监护病房
DOI:
基金项目:重庆市自然科学基金(CSTC2009BB5061);重庆市人事部科研基金(09958013)
Clinical characteristics and drug resistance analysis of Klebsiella pneumoniae infection in ICU
WANG Chunrui,YUAN Zhe,ZHOU Hongyu,YANG Zheng
(Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University;Management Section, The First Affiliated Hospital of Chongqing Medical University;Department of Infectious Diseases, Jingzhou Hospital)
Abstract:
Objective To analyze the clinical characteristics and drug resistance of K. pneumoniae in ICU, and provide evidence for the rational use of antibiotics in clinical practice. Methods The K.pneumoniae infections in ICU from January 2014 to December 2016 were analyzed. Drug susceptibility test adopted disk diffusion method. Extended-spectrum β-lactamase was detected with doubledisc synergy test.Results K. pneumoniae infection in our hospital ICU was common in elderly patients with multiple predisposing factors. Respiratory tract was the main infection site. Patients with CREKp had a high mortality rate. Most of them were associated with septic shock or multiple organ failure. The resistance rate of the detected strains to the commonly used antibiotics increased to varying degrees. Particularly CREKp strains was gradually increasing and characterized by pan-drug resistance, only sensitive to tigecycline and minocycline.Conclusion The incidence of K. pneumoniae infection in ICU is high and the disease is serious. The mortality of CREKp infection is high. We should fully recognize its seriousness. It is especially important to guide the clinical selection of appropriate antibiotics based drug susceptibility testing results.
Key words:  Klebsiella pneumoniae  Antibiotic resistance  Extended spectrum beta lactamase  Intensive care unit

用微信扫一扫

用微信扫一扫